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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Case Report

Successful Pregnancy and Delivery after Premature Ovarian Insufficiency Combined with Undifferentiated Connective Tissue Disease: A Case Report

Author(s): Mengyang Du, Liying Peng, Ruixiu Zhang and Shihua Bao*

Volume 24, Issue 7, 2024

Published on: 03 November, 2023

Page: [840 - 844] Pages: 5

DOI: 10.2174/0118715303248685231023114212

Price: $65

Abstract

Background: Premature ovarian insufficiency (POI) is extremely rare in the early stage of undifferentiated connective tissue disease. Patients with POI find it difficult to achieve successful pregnancy and delivery.

Case Presentation: A 27-year-old female visited an outpatient department for premature ovarian insufficiency (POI) and infertility. She had regular menstrual periods since she was 14 years old and had no history of systemic disease. Laboratory tests showed low estrogen (15 ng/L, range 19.6-144.2 ng/L), elevated follicle-stimulating hormone (34 U/L), low anti-Mullerian hormone (0.1 μg/L), normal prolactin (11.48 ng/mL), and thyroid stimulating hormone (TSH) levels (0.97 mU/L). She demonstrated smaller bilateral ovarian volume and positivity to antinuclear and antiphospholipid antibodies. After the failure of conventional drug therapy and in vitro fertilization, the patient became pregnant naturally after treatment with glucocorticoids.

Conclusion: Immunosuppression could help improve ovarian function and pregnancy outcomes in POI patients, but the therapeutic mechanisms are not clear and should be elucidated with more clinical studies.

Keywords: Premature ovarian insufficiency (POI), undifferentiated connective tissue disease (UCTD), antinuclear, antiphospholipid antibodies, infertility, immunosuppressive agent, glucocorticoid, case report.

« Previous Next »
[1]
Mosca, M.; Tani, C.; Bombardieri, S. Undifferentiated connective tissue diseases (UCTD): A new frontier for rheumatology. Best Pract. Res. Clin. Rheumatol., 2007, 21(6), 1011-1023.
[http://dx.doi.org/10.1016/j.berh.2007.09.004] [PMID: 18068858]
[2]
Mosca, M.; Tavoni, A.; Neri, R.; Bencivelli, W.; Bombardieri, S. Undifferentiated connective tissue diseases: The clinical and serological profiles of 91 patients followed for at least 1 year. Lupus, 1998, 7(2), 95-100.
[http://dx.doi.org/10.1191/096120398678919787] [PMID: 9541093]
[3]
Vilá, L.; Mayor, A.; Valent, A.; Garc, M.; Vilá, S. Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus. Lupus, 2000, 9(2), 110-115.
[http://dx.doi.org/10.1191/096120300678828073] [PMID: 10787007]
[4]
Mosca, M.; Neri, R.; Bencivelli, W.; Tavoni, A.; Bombardieri, S. Undifferentiated connective tissue disease: Analysis of 83 patients with a minimum followup of 5 years. J. Rheumatol., 2002, 29(11), 2345-2349.
[PMID: 12415590]
[5]
Gleicher, N.; Pratt, D.; Dudkiewicz, A. What do we really know about autoantibody abnormalities and reproductive failure: A critical review. Autoimmunity, 1993, 16(2), 115-140.
[http://dx.doi.org/10.3109/08916939308993318] [PMID: 8180317]
[6]
Scott, J.S. Immunological diseases and pregnancy. BMJ, 1966, 1(5503), 1559-1567.
[http://dx.doi.org/10.1136/bmj.1.5503.1559] [PMID: 5328531]
[7]
Kaider, A.S.; Kaider, B.D.; Janowicz, P.B.; Roussev, R.G. Immunodiagnostic evaluation in women with reproductive failure. Am. J. Reprod. Immunol., 1999, 42(6), 335-346.
[http://dx.doi.org/10.1111/j.1600-0897.1999.tb00110.x] [PMID: 10622463]
[8]
Luborsky, J.; Llanes, B.; Roussev, R.; Coulam, C. Ovarian antibodies, FSH and inhibin B: Independent markers associated with unexplained infertility. Hum. Reprod., 2000, 15(5), 1046-1051.
[http://dx.doi.org/10.1093/humrep/15.5.1046] [PMID: 10783349]
[9]
Ni, R.; Lu, L. Comment on: Pregnancy and undifferentiated connective tissue disease: outcome and risk of flare in 100 pregnancies. Rheumatology, 2020, 59(6), 1457-1458.
[http://dx.doi.org/10.1093/rheumatology/keaa065] [PMID: 32176284]
[10]
Chon, S.J.; Umair, Z.; Yoon, M.S. Premature ovarian insufficiency: Past, present, and future. Front. Cell Dev. Biol., 2021, 9, 672890.
[http://dx.doi.org/10.3389/fcell.2021.672890] [PMID: 34041247]
[11]
Baek, J.S. A clinical study on one case of a spontaneous pregnancy with premature ovarian failure. J. Korean Obstet. Gynecol., 2018, 3102-3195.
[12]
Torrealday, S.; Kodaman, P.; Pal, L. Premature Ovarian Insufficiency - an update on recent advances in understanding and management. F1000 Res., 2017, 6, 2069.
[http://dx.doi.org/10.12688/f1000research.11948.1]
[13]
Rudnicka, E.; Kruszewska, J.; Klicka, K.; Kowalczyk, J.; Grymowicz, M.; Skórska, J. Pięta, W.; Smolarczyk, R. Premature ovarian insufficiency – aetiopathology, epidemiology, and diagnostic evaluation. Przegl. Menopauz., 2018, 17(3), 105-108.
[http://dx.doi.org/10.5114/pm.2018.78550] [PMID: 30357004]
[14]
Szeliga, A.; Calik-Ksepka, A.; Maciejewska-Jeske, M.; Grymowicz, M.; Smolarczyk, K.; Kostrzak, A.; Smolarczyk, R.; Rudnicka, E.; Meczekalski, B. Autoimmune diseases in patients with premature ovarian insufficiency-our current state of knowledge. Int. J. Mol. Sci., 2021, 22(5), 2594.
[http://dx.doi.org/10.3390/ijms22052594] [PMID: 33807517]
[15]
Ishizuka, B.; Kudo, Y.; Amemiya, A.; Yamada, H.; Matsuda, T.; Ogata, T. Anti-nuclear antibodies in patients with premature ovarian failure. Hum. Reprod., 1999, 14(1), 70-75.
[http://dx.doi.org/10.1093/humrep/14.1.70] [PMID: 10374097]
[16]
Corenblum, B.; Rowe, T.; Taylor, P.J. High-dose, short-term glucocorticoids for the treatment of infertility resulting from premature ovarian failure. Fertil. Steril., 1993, 59(5), 988-991.
[http://dx.doi.org/10.1016/S0015-0282(16)55915-9] [PMID: 8486200]
[17]
Shi, X.; Li, N.; Liao, C.; Shu, Q.; Zhu, F. Glucocorticoid or androgen for autoimmune premature ovary failure in mice. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2009, 34(7), 576-581.
[PMID: 19648666]
[18]
Kadam, K.M.; Mande, P.V.; Gawas, N.; Ahire, S.; Khole, L.V.V. Autoantibodies to heat-shock protein, HSPA5, and epitope spreading: High-dose dexamethasone therapy rescues ovarian function in experimental autoimmune ovarian insufficiency mouse model. Am. J. Reprod. Immunol., 2016, 75(5), 580-593.
[http://dx.doi.org/10.1111/aji.12494] [PMID: 26840828]
[19]
Illera, J.C.; Silván, G.; Martínez, M.M.; Blass, A.; Peña, L. The effect of dexamethasone on disruption of ovarian steroid levels and receptors in female rats. J. Physiol. Biochem., 2005, 61(3), 429-438.
[http://dx.doi.org/10.1007/BF03168449] [PMID: 16440597]
[20]
Barbarino-Monnier, P.; Gobert, B.; Guillet-May, F.; Béné, M.C.; Barbarino, A.; Foliguet, B.; Faure, G.C. Ovarian autoimmunity and corticotherapy in an in-vitro fertilization attempt. Hum. Reprod., 1995, 10(8), 2006-2007.
[http://dx.doi.org/10.1093/oxfordjournals.humrep.a136225] [PMID: 8567831]

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